COVID-19 Vaccine Acceptance Among Dental Professionals Based on Employment Status During the Pandemic.

The COVID-19 pandemic spread rapidly across the globe, leading governments to impose prolonged lockdowns on both movement and commerce. Although lockdowns decrease the rates of novel infections, they can have devastating consequences on the economy and employment levels. One of the most severely affected sectors during this crisis has been dental medicine. Dental professionals are uniquely exposed to environments with high levels of occupational hazards, conferring additional risks of viral exposure and transmission. We analyzed 506 anonymous questionnaires completed by dentists and residents regarding acceptance of a future potential SARS-CoV-2 vaccine. Our results demonstrate a statistically significant correlation between the individual's unemployment rate and their willingness to inoculate with a SARS-CoV-2 vaccine when it becomes available. This information can be used to predict trends of vaccine acceptance or rejection based on economic burden during the COVID-19 pandemic by different sectors as part of the preparedness toward global vaccination programs.

Palatal Erythema with Histological Psoriasiform Pattern: An Enigmatic Oral Finding Shared by a Range of Conditions.

Long standing, asymptomatic, well-demarcated erythema of the hard palate with a histopathological psoriasiform pattern comprises a challenging diagnosis. We present a series of patients with such clinical and histological findings and discuss the possible diagnoses. We collected all patients with palatal erythematous lesions that had well-documented clinical examination. Excluded were patients with definitive diagnosis of oral infections (e.g. candidiasis), neoplastic/pre-neoplastic lesions, auto-immune diseases, reactive lesions, blood disorders and vascular malformations. Thirteen patients (six females, seven males, age range 11-56 years) were included. Histopathologically, a psoriasiform pattern was observed in all biopsied lesions. One patient was diagnosed with hereditary mucoepithelial dysplasia (HMD) and four with cutaneous psoriasis. The remaining eight patients were otherwise healthy. A combination of persistent, asymptomatic palatal erythematous lesion with psoriasis-like histopathology may represent an oral manifestation of HMD or psoriasis, concomitant to extra-oral features. In lack of any known medical background, the term "oral psoriasiform mucositis" is suggested.

Oral lichen planus patients exhibit consistent chromosomal numerical aberrations: A follow-up analysis.

BACKGROUND: Oral lichen planus (OLP) carries an increased risk for malignant transformation with aneuploid cells (ACs) being found in brush samples of a quarter of patients with OLP. METHODS: Patients with OLP were followed and repeated brush samples were simultaneously analyzed for morphology and fluorescent in situ hybridization (FISH) using centromeric probes for chromosomes 2 and 8. RESULTS: Three patients with a high proportion of ACs developed oral cancer. Fifteen patients had ≥1% ACs (13 in affected sites and 2 in nonaffected sites), whereas only 2 of the 15 patients with <1% ACs in the first sample had ≥1% ACs in the second sample. A strong positive correlation between the results of the initial and repeated samples was found. CONCLUSION: High proportion of ACs in brush samples from patients with OLP may imply an impending malignant transformation. As FISH analysis is consistent over time, it can be used to identify a subgroup of patients who would require close follow-up. © 2015 Wiley Periodicals, Inc. Head Neck 38: E741-E746, 2016.

BRAF and GNAQ mutations in melanocytic tumors of the oral cavity.

OBJECTIVE: The genetic factors participating in oral melanoma evolution have not been studied extensively. We aimed to analyze the prevalence of BRAF and GNAQ mutations in a series of oral melanocytic tumors, nevi, and melanomas. STUDY DESIGN: The study group consisted of 4 melanomas and 10 nevi (6 intramucosal, 4 blue nevi). DNA was extracted from paraffin-embedded tissue sections, and mutations in GNAQ and BRAF were analyzed with the use of mass spectrometery. RESULTS: V600E point mutation was identified in the BRAF gene in 3 intramucosal nevi and in 2 melanomas. Only 1 blue nevus harbored the GNAQ209 mutation. None of the BRAF-positive samples harbored GNAQ mutations. CONCLUSIONS: The finding of BRAF mutations in oral benign and malignant melanocytic lesions points to a potential initiating role of BRAF in malignant transformation, which may have important therapeutic implications as those with BRAF mutations may benefit from specific treatment using RAF inhibitors.

Noninvasive detection of aneuploid cells in laryngeal epithelial precursor lesions.

BACKGROUND: Most cases of laryngeal cancer are preceded by precursor lesions which, if left untreated, can progress toward an invasive cancer. The objective of this study was to investigate the presence of chromosomal numerical aberrations in cells that were collected by noninvasive brush sampling from laryngeal lesions. METHODS: Laryngeal brush samples from 52 patients were analyzed simultaneously for morphology and fluorescence in situ hybridization (FISH) using centromeric probes for chromosome 17, chromosome 8, and a locus-specific instability (LSI) v-myc avian myelocytomatosis viral oncogene homolog (myc) proto-oncogene protein (C-MYC) probe for the MYC gene. The patients were divided according to histopathologic diagnosis. Group 1 included patients with squamous cell carcinoma, carcinoma in situ, and severe dysplasia; Group 2 included patients with moderate dysplasia, mild dysplasia, and hyperplasia; and Group 3 included patients with benign nondysplastic lesions. RESULTS: The proportion of cells with MYC and chromosome 8 gains demonstrated significant trends toward being the highest in Group 1 and the lowest in Group 3 (P = .001 and P = .003, respectively). No significant trend was observed for chromosome 17. Mann-Whitney Bonferroni-corrected analyses revealed that the most significant contribution was the difference between Groups 1 and 3 (P = .0195 for MYC gains and P = .036 for chromosome 8 gains). When using a cutoff point of 4% aneuploid cells (ACs), both MYC and chromosome 8 differed significantly between groups (P = .030 and P = .037, respectively). CONCLUSIONS: The current results suggested that FISH analysis of brush samples obtained noninvasively from suspicious laryngeal lesions can augment the clinical examination in predicting the nature of the lesions and can aid clinicians in monitoring and follow-up of high-risk patients. Cancer (Cancer Cytopathol) 2011. © 2011 American Cancer Society.

Mutational analysis of PTEN/PIK3CA/AKT pathway in oral squamous cell carcinoma.

The phosphoinositide 3-kinase (PI3K)/v-akt murine thymoma (AKT) viral oncogene pathway is involved in regulating the signaling of multiple biological processes such as apoptosis, metabolism, cell proliferation, and cell growth. Mutations in the genes associated with the PI3K/AKT pathway including PI3K, AKT, RAS and PTEN, are infrequently found within head and neck squamous cell carcinoma and more specifically are rarely reported in oral squamous cell carcinoma (OSCC) cases. We aimed to investigate the frequency of mutations in AKT1, PTEN, PIK3CA, and RAS (K-RAS, N-RAS, H-RAS) genes in 37 cases of oral squamous cell carcinoma (OSCC). Mutational analysis of PTEN, RAS, PIK3CA and AKT genes was performed using chip-based matrix-assisted laser desorption time-of-flight (MALDI-TOF) mass spectrometry and by direct sequencing. The only gene mutated in our series was the PIK3CA. Missense mutations of the PIK3CA gene were found in 4 of our cases (10.8%); no correlation has been found with oral location, stage and survival. The absence of mutations in AKT1, PTEN, and RAS genes in the present study is in accordance with previous studies confirming that these genes are rarely mutated in OSCC. Our data confirm that PIK3CA is important to OSCC tumorigenesis and can contribute to oncogene activation of the PIK3CA/AKT pathway in OSCC. The knowledge of the PIK3CA's involvement in OSCC is important because a specific kinase inhibitor could be considered as a future therapeutic option for OSCC patients with PIK3CA mutations.

Wrong tooth extraction: root cause analysis.

OBJECTIVE: Errors made by clinicians in dental practice require changes in the original planning of patient management. The purpose of this study was to analyze events that led to wrong tooth extraction. METHOD AND MATERIALS: A total of 54 insurance claims for wrong tooth extractions were reported and evaluated by Medical Consultants International from 1993 to 2004. Data were collected and analyzed according to parameters regarding the clinician who performed the procedure, the nature of the referral for extraction, the demographics of the patient, the venue in which the extraction took place, the reason for the error, and the nature of the insurance claim. RESULTS: General practitioners performed 72% of the extractions, 49% of the referring clinicians were orthodontists, 74% of the errors were made during extraction, and 77% of the errors were made in polyclinics. CONCLUSIONS: Errors during treatment and poor communication among clinicians led to extraction of the wrong teeth. This can be avoided by greater caution on the part of the extracting clinician when following the treatment plan. Guidelines toward this end are recommended.

Chromosomal numerical aberrations in apparently normal oral mucosa of heavy smokers affected by lung cancer.

Cigarette smoke creates a field of injury in the epithelial lining of the entire respiratory tract causing an increased risk for the development of malignant lesions. It is conceivable, therefore, that early genetic alterations, can be detected in oral mucosa of heavy smokers mainly those affected by lung cancer. As aneuploidy was shown to be an early event in oral carcinogenesis, we aimed to investigate the prevalence of aneuploid cells (ACs) in samples obtained from apparently normal looking oral mucosa of heavy smokers affected by lung cancer (LC). Two brush samples were collected from the oral mucosa of 152 subjects; 31 heavy smokers with LC, 59 heavy smokers without LC and 62 never-smokers. The samples were simultaneously analyzed for morphology and fluorescent in situ hybridization (FISH) using chromosomes 2 and 8 centromeric probes. Over 2% ACs were found in 23% of heavy smokers with LC compared to 12% in heavy smokers without LC and 5% of the never-smokers group (P=0.015). A trend was also noticed when comparing the group of heavy smokers without LC with the never-smokers (P=0.198). We conclude that heavy smokers harbour detectable chromosomal numerical aberrations in oral epithelial cells of normal looking mucosa. These aberrations are more frequently found in heavy smokers affected by LC.